ABSTRACT: This study used computed tomography (CT) to identify anatomic features of the awake upper respiratory tract (URT) that correlate with severity of obstructive sleep apnea (OSA).
An IRB approved radiographic study of 80 patients with OSA and 56 patients from the general population.
Awake, noncontrast CT was performed from the skull base to the thoracic inlet in patients with OSA. Cross-sectional measurements of the retropalatal and retrolingual airways were made along with the size of the cervicomandibular ring and the percentage neck fat. The mandibular plane to hyoid distance, neck length, and laryngeal descent were also recorded. The posterior tongue fat content was estimated using the Hounsfield unit for radiodensity. The radiographic data were then compared with clinical information, including apnea-hypopnea index (AHI), body mass index, and neck circumference using linear regression.
AHI increases with smaller retrolingual cross-sectional airway (P = .0026) and increasing mandibular plane to hyoid distance (P = .0003) but not retropalatal airway or laryngeal descent. The posterior tongue is hypodense with higher fat content than other muscles of the head and neck.
This study describes anatomic findings of the retrolingual airway in patients that correlate with OSA and can be measured on an upper airway CT. Patients with severe OSA (AHI > or = 40) tend to have retrolingual airways less than 4% of the cross-sectional area of the cervicomandibular ring. The retrolingual airspace is the major site of obstruction in severe OSA and should be carefully evaluated before surgical treatment is considered.
The Laryngoscope 06/2008; 118(8):1486-92. · 1.75 Impact Factor
ABSTRACT: The presumed pathogenesis of posttraumatic anosmia is stretching or shearing of the olfactory nerves in a coup-contracoup head contusion. Direct injury to the brain is an alternate mechanism of injury. In this study we report a case where direct injury to the brain is the probable mechanism of injury.
A case report was performed.
A 55-year-old man presented with loss of smell beginning 1 month after a closed head injury with loss of consciousness. The MRI showed posttraumatic scarring in the region of the olfactory bulbs.
This case suggests that central nervous system injury to the olfactory bulbs and tracts may be a mechanism of posttraumatic anosmia.
American Journal of Rhinology 22(6):606-7. · 1.36 Impact Factor
ABSTRACT: Snoring in college students may be the earliest presentation of adult sleep-disordered breathing, yet the literature contains few studies that demonstrate its effects on learning or whether early diagnosis leads to interruption of disease progression or prevention of comorbidities.
The authors conducted this study in January-April 2004 to assess the prevalence of snoring in college students (N = 2,200).
They developed a questionnaire on sleep behaviors and distributed it to 18- to 25-year-old undergraduates at a California university.
Almost one-third (30%) of participants reported snoring. The prevalence of snoring was higher among men than women (42% and 25%, respectively). The prevalence of self-reported snoring was highest in Asian students (37%).
Snoring is highly prevalent in college students; prevalence is higher in men than women, correlates with body mass index, and varies by ethnicity.
Journal of American College Health 57(1):45-52. · 1.45 Impact Factor